Division of Psychiatry, Faculty of Brain Sciences, University College London, UK.
Department of Rehabilitation, National University Hospital, Singapore.
Gerontologist. 2022 Apr 20;62(4):629-641. doi: 10.1093/geront/gnab047.
Despite the importance of meaningful activity in mild dementia, only limited data are available on the development of interventions supporting people with mild dementia to engage in meaningful activity. In this article, we describe the development of an intervention that responds to this need.
Intervention mapping (IM), an evidence-based approach, was used to develop STAYING ACTIVE (STAYing well and active-schedulINg meaninGful and enjoyAble aCTIvities to promote Vitality and wEll-being in mild dementia). The first step, a needs assessment, comprised a literature review, focus groups, and individual interviews with service users. Performance objectives of the intervention were formulated in Step 2, followed by the development of theory-based methods in Step 3. In Step 4, the new intervention was developed based on data collected in previous steps, existing interventions, and pilot testing. Qualitative data were analyzed using framework analysis.
The needs assessment indicated that people with dementia and their carers view "staying active" as an important part of "enjoying life." Adapting to loss through compensation and receiving support were key facilitators of engaging in meaningful activity. Ecological, psychosocial, and activity-oriented theories guided the development of theory-based intervention strategies, which were based on awareness, skills, and addressing barriers of meaningful activity.
STAYING ACTIVE is grounded on theory, and service user experiences and aims at promoting meaningful activity in mild dementia. The IM framework may be useful in the development of future psychosocial interventions for people with dementia, facilitating transparency when efficacy is evaluated.
尽管有意义的活动对轻度痴呆症患者非常重要,但目前仅有有限的数据可以了解支持轻度痴呆症患者参与有意义活动的干预措施的发展情况。在本文中,我们描述了一种满足这种需求的干预措施的开发过程。
采用循证方法——干预映射法(IM)来开发 STAYING ACTIVE(保持活跃和积极安排有意义和愉快的活动,以促进轻度痴呆症患者的活力和幸福感)。第一步是需求评估,包括文献综述、焦点小组和与服务使用者的个人访谈。第二步制定干预的绩效目标,第三步制定基于理论的方法。第四步基于前几个步骤、现有干预措施和试点测试中收集的数据来开发新的干预措施。使用框架分析对定性数据进行分析。
需求评估表明,痴呆症患者及其照顾者将“保持活跃”视为“享受生活”的重要组成部分。通过补偿来适应损失和获得支持是参与有意义活动的关键促进因素。生态、心理社会和活动导向理论指导了基于理论的干预策略的发展,这些策略基于对有意义活动的意识、技能和解决障碍。
STAYING ACTIVE 基于理论和服务使用者的经验,旨在促进轻度痴呆症患者的有意义活动。IM 框架在评估疗效时可以提高心理社会干预措施对痴呆症患者的透明度,从而为未来的开发提供有用的参考。